Individual
PIA I TODRAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
255 REVERE DR, NORTHBROOK, IL 60062-1564
(847) 412-4350
Mailing address
255 REVERE DR, NORTHBROOK, IL 60062-1564
(847) 412-4350
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
178-005264
IL
103TC0700X
Clinical Psychologist
Primary
071-007800
IL
Other
Enumeration date
12/28/2007
Last updated
10/07/2010
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